Provider Demographics
NPI:1386813889
Name:VISUALEYES EYECARE, P.C.
Entity Type:Organization
Organization Name:VISUALEYES EYECARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:N
Authorized Official - Last Name:QUARNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-858-2020
Mailing Address - Street 1:332 E ASPEN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-2204
Mailing Address - Country:US
Mailing Address - Phone:970-858-2020
Mailing Address - Fax:970-858-6601
Practice Address - Street 1:332 E ASPEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-2204
Practice Address - Country:US
Practice Address - Phone:970-858-2020
Practice Address - Fax:970-858-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO2351152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU99497Medicare UPIN
CO534468Medicare PIN